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Home >> Publications >> Growth in Virologically Suppressed HIV-Positive Children on Antiretroviral Therapy: Individual and Population-level References.

Publication

Author(s):

Keiser O, Blaser N, Davies MA, Wessa P, Eley B, Moultrie H, Rabie H, Technau KG, Ndirangu J, Garone D, Giddy J, Grimwood A, Gsponer T, Egger M; for IeDEA Southern Africa.

Pub Title:

Growth in Virologically Suppressed HIV-Positive Children on Antiretroviral Therapy: Individual and Population-level References.

Pub Date:

Oct 1 2015

Pub Region(s):

Southern Africa

Page Number:
254- 259

Journal:

Title: 
Pediatr Infect Dis J
Link: 
http://ovidsp.tx.ovid.com/sp-3.16.0b/ovidweb.cgi?QS2=434f4e1a73d37e8c504983e01e46c99a4143b0122e794e23aac6aa393f0921f0e6b3ef5d7b88d7589f8223612be63c491d1e1dd94e5768fe7ed3cb372a7d08c38ef428d6915552e7960ed7047bc99d8e67e85c29300de3f5a072128f1dbd245523f803298b

PubMed: 26192393

BACKGROUND:

Combination antiretroviral therapy (ART) suppresses viral replication in HIV-infected children. The growth of virologically suppressedchildren on ART has not been well documented. We aimed to develop dynamic reference curves for weight-for-age Z scores (WAZ) and height-for-age Z scores (HAZ).

METHODS:

Children aged <11 years at ART initiation with continuously undetectable viral loads (<400 copies/mL) treated at 7 South African ART programs with routine viral load monitoring were included. We used multilevel models to define trajectories of WAZ and HAZ up to 3 years and developed a web application to monitor trajectories in individual children.

RESULTS:

A total of 4876 children were followed for 7407 person-years. Analyses were stratified by baseline Z scores and age, which were the most important predictors of growth response. The youngest children showed the most pronounced increase in weight and height initially but catch-up growth stagnated after 1-2 years. Three years after starting ART, WAZ ranged from -2.2 [95% prediction interval (PrI), -5.6 to 0.8] in children with baseline age >5 years and Z score less than -3 to 0.0 (95% PrI, -2.7 to 2.4) in children with baseline age <2 years and WAZ greater than -1. For HAZ, the corresponding range was -2.3 (95% PrI, -4.9 to 0.3) in children with baseline age >5 years and Z score less than -3 to 0.3 (95% PrI, -3.1 to 3.4) in children with baseline age 2-5 years and HAZ greater than -1.

CONCLUSIONS:

We have developed an online tool to calculate reference trajectories in fully suppressed children. The web application could help to define "optimal" growth response and identify children with treatment failure.

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Citation:

Keiser O, Blaser N, Davies MA, Wessa P, Eley B, Moultrie H, Rabie H, Technau KG, Ndirangu J, Garone D, et al. Growth in Virologically Suppressed HIV-Positive Children on Antiretroviral Therapy: Individual and Population-level References. Pediatr Infect Dis J. 2015 Oct;34(10):e254-e259. PubMed PMID: 26192393.